From e-Health to i-Health...this is no accident

posted 19 May 2011, 10:33 by Michael Boniface

In 2001, the British Medical Journal decided
to ban the word “accident” in relation to injuries or events that produce them.
10 years later e-Health initiatives across Europe still fail to deliver on
their promises of greater efficiency for healthcare professionals and improved
health outcomes for patients. Information integration, data fusion and decision
support is a huge challenge but information integration that is distributed
across regional and national domains of control and where there can be “no
accidents” seems unlikely.

History shows that disruptive technology can only have a
successful impact through a balanced approach that addresses both technical and
socio-economic drivers (e.g. the failure of Grid computing to become
ubiquitous). This is true even if huge budgets are used to achieve relatively
modest levels of innovation (e.g. the UK’s NHS IT Infrastructure project).

But how can the Future Internet provide the
resilience, reliability and dependability for stakeholders whose appetite for
risk is close to zero and whose application requirements are as complex as
human life itself?

These topics were debated at FIA Budapest during the
session on Dynamically Adaptive FI Applications: Beyond Adaptive Services. The session explored application
scenarios from health, logistics and media with each posing driving
requirements for adaptability in service infrastructures. Katarzyna Wac,
University of Geneva, argued that an integrated health care approach supported
by Future Internet technologies “anytime-anywhere-anyhow” was a key to achieve
the ambitious goal of efficient and effective management of diseases and
enabling the self-management of patients ‘on-the-move’. These ideas were
mirrored by Nuria De Lama, ATOS Origin, who talked about e-Health in the FI-PPP,
following on from ideas presented by ATOS at FIA Valencia last year.

The technical aspects of health scenarios are not without
significant challenges but maybe new thinking and cultural attitudes are
necessary for ICT to have an impact in healthcare delivery.A seed was planted by Dr Heikki Huomo, Director of the
Center for Internet Excellence, who argued the need to exploit the
network effect and move from e-Health to i-Health. Heikki described how online
communities and social media could support the wellbeing of individuals,
contribute to wider societal health objectives and deliver massive
efficiencies. Online support groups and real-time identification of pandemics
were both examples of how communities and their data could deliver benefits to
the healthcare system. Conversations between mothers on social networks about
problems with flu vaccinations
could be used to quickly identify trends in large populations, certainly more quickly than
healthcare providers collecting and analysing data from each doctor.

We are already seeing i-Health emerging with services such as Moodscope reaching a
membership of 25000. As is often the case in these discussions, we are back to
the puzzling issue of participation and privacy. Many people would rather share
personal and sensitive information in trusted online groups hosted by a
third-party service providers than allow their data to be distributed within
systems run by governments. Of course i-Health is unlikely to replace e-Health
but the two approaches should be considered complimentary. The challenge for dynamic adaptability
will therefore be on the co-existence and cooperation between different
collaboration architectures designed for community sharing (i-Health) and for
structured healthcare business processes (e-Health).

So, the societal process of shifting the blame will be
problematic for engineers developing dynamic and adaptive services in the
Future Internet. We expect system behaviours to be increasingly difficult to
characterise, monitor and control considering the high levels of
interconnectivity between services. In a culture where there can be “no
accident” the events that produce misbehaviour will have significant
consequences, and maybe the simplicity of i-Health will allow ICT to deliver
greater impact in the health domain in spite of the linguistic endeavours of some.